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Flashcards in Hematology Lab Values Deck (23)
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1

Increased Hematocrit

Primary/secondary polycythemia

Congenital/acquired heart and lung disease

High altitude

Heavy smoking

2

Hematocrit

Calculated from MCV and red cell number

Percentage volume of red cells in a given volume of blood

Men normals: 40-54%

Women normals: 37-47%

3

Decreased Hematocrit

Anemia - iron, megaloblastic (B12), chronic disease, sickle cell

Acute/chronic blood loss

Hemolysis

Dilution

Alcohol/drugs

4

MCH

Mean Cellular (Corpuscular) Hemoglobin

27-31 pg

Amount of hemoglobin in the average red cell

5

Increased MCH

Decreased MCH

Increased: Macrocytosis (megaloblastic anemia, high reticulocyte count)

Decreased: Microcytosis (iron deficiency, sideroblastic anemia, thalassemia)

6

MCHC

Mean Corpuscular Hemoglobin Concentration

33-37 g/dL

Average concentration of Hgb in a given volume of red cells

7

Increased MCHC

Decreased MCHC

 

Increased: Very severe prolonged dehydration; Spherocytosis

Decreased: Iron deficiency anemia, overhydration, thalassemia, sideroblastic anemia

8

MCV

Mean Corpuscular Volume

78-98

Average volume of rbc

Measured directly with the automated cell counter

9

Normal MCV

Anemia of chronic disease

Acute blood loss

Primary bone marrow failure

10

Increased/Macrocytosis MCV

Megaloblastic anemia (B12/folate)

Macrocytic normoblastic anemia

Anemia of chronic disease

11

Decreased/microcytosis MCV

Iron deficiency

Thalassemia

Polycythemia

12

RDW

Red Cell Distribution Width

11.5-14.5%

Measure of the degree of anisocytosis (variation of rbc size)

Determined with an automatic counter

13

Increased RDW

Many anemia types - iron, pernicious, folate, thalassemia

Liver disease

14

Basophilic Stippling DDx

Lead or heavy metal poisoning

Thalassemia

Severe anemia

15

Burr Cells (Acanthocytes)

Severe liver disease

High levels of bile, fatty acids, or toxins

16

Heinz Bodies

Howell-Jolly Bodies

Sickling

Heinz Bodies: Drug-induced hemolysis

Howell-Jolly Bodies: Asplenia

Sickling: sickle cell anemia

17

Helmet Cells

Microangiopathic hemolysis (TTP/HUS/HELLP)

Hemolytic transfusion reaction

Transplant rejection

18

Nucleated RBCs

Severe bone marrow stress

Marrow replacement by tumor

Extramedullary hematopoiesis

19

Polychromasia

Bluish red cell on routine Wright stain

Suggests reticulocytes

20

Schistocytes DDx

DIC

Microangiopathic anemia

Severe burns

Drug effect

21

Spherocytes DDx

Hereditary spherocytosis

Immune hemolysis

Severe burns

ABO transfusion reaction

22

Target Cells (Leptocytes)

Thalassemia

Hemoglobinopathies

Liver disease

Any hypochromic anemia

Splenectomy aftermath

23

WBC Morphology Abnormalities

Auer Rods: AML

Dohle Inclusion Bodies: Severe infection, burns, malignancy, pregnancy

Hypersegmentation: Megaloblastic anemia

Toxic Granulation: Severe illness (sepsis, burn, high fever)